| NPI | 1629336128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NV 22619) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NV 22619) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA A126409) | |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NY 286986) | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NV 22619) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NV 22619) | |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2023-01-30 |